Saturday, November 07, 2009
Statement on H.R. 3962, the Affordable Health Care for America Act
Health Care Reform:  A Moral and Economic Imperative

Dear Madame Speaker:

I rise today in support of H.R. 3962, the Affordable Health Care for America Act, offered by Rep. John Dingell of Michigan. I ask all of my colleagues to support this historic bill before us. It expands coverage to 36 million uninsured Americans, ensures that patients and physicians make their own health care choices, reduces administrative costs, invests in wellness and prevention, reforms the insurance industry by ending discriminatory practices, especially pre-existing conditions and health disparities, and allows young adults to remain on their parents’ insurance policy until the age of 27.  

I have held numerous town hall meetings in my district to listen to the views of my constituents. My office has received numerous calls, emails, and letters on this subject, with an overwhelming majority asking me to vote YES on the bill because America cannot wait any longer for health care insurance reform. More than 300 groups, representing millions of Americans, have expressed their support for the bill, including the American Association of Retired Persons (AARP), the American Cancer Society, the United Auto Workers (UAW), the AFL-CIO, the SEIU, Families USA, and the National Committee to Preserve Social Security and Medicare. The groups expressing their support include a broad range, including groups representing doctors, seniors, small business, youth, women, persons with disabilities, consumers, and patients. 

Health care insurance reform is not a Republican or Democratic issue—it is an American issue. Under a Democratic President, we witnessed the beginnings of health care reform with Medicaid and Medicare in the 1960s. Under another Democratic President, we will witness the second coming of true health care reform.    

Today’s vote will mark a change in our country where every American will know that health care is a top priority for this country. When I was a newly elected Member to the U.S. House of Representatives, Congress was in the throes of reforming health maintenance organizations (HMOs). While this was well intended, at the time, I asked, “What about those millions of people who go to work each and every day, who care for our senior citizens in nursing homes, who clean our bathrooms, cook our food, clean our streets, and send their children to college, but whose employers do not provide health care?” What happened is that those individuals did not have health care coverage, period. Now is the time to help those janitors, street sweepers, short-order cooks, childcare workers, home health care providers, and small businesses so that those workers, too, will be able to have health care.

The 111th Congress has taken bold steps to provide more access to health care for Americans. While we have expanded health coverage to more than five million uninsured children through the passage of the State Comprehensive Health Improvement Plan (SCHIP), we must complete what we started. Access to health care is vital to the health of not only individual Americans but also to the American economy. 

Even before our recent economic crisis, health care was getting more expensive; what few benefits were offered were eroding, and even more people were losing coverage.  In 2007, according to various sources, 45 million Americans were uninsured; this number is an increase over 2000’s 38.7 uninsured Americans. And this is the uninsured; we are not even discussing the millions more senior citizens, working poor, and families who are underinsured. I am talking about seniors who have to choose between eating or buying their prescriptions. I am talking about those families who have to choose between taking their child to the doctor or purchasing food for the week. The economic crisis has only made this situation worse.

The bankruptcy of the automobile industry, the closing of auto dealerships, and the crisis faced by automobile suppliers have caused thousands more in our nation and, in particular, the state of Michigan to lose their employee health benefits.

Our version of health care reform, the Affordable Health Care for America Act, has four key highlights for Americans and American businesses: lower costs, greater choice, higher quality, and peace of mind. As Health and Human Services Secretary Sebelius said earlier, if we do nothing to reform health care, we will continue to live sicker, die faster, and pay twice as much. 

Health care reform legislation should require coverage of the full range of women's reproductive health services. H.R. 3962 protects these rights and ensures that all women have access to a health care plan that meets their needs while respecting current law. The Stupak amendment would limit access to reproductive care in the private and public options and does not allow citizens to pay for the procedure out of their own pockets. I voted against the Stupak amendment. 

Health care reform will provide lower health care costs. Under the Affordable Health Care for America Act, there will be NO more co-pays or deductibles for preventive care. NO more rate increases or exclusions for pre-existing conditions, gender, or occupation. There will be an annual cap on the out of pocket expenses for individuals and businesses. Finally, for the first time, there will be guaranteed and affordable oral, hearing, and vision care for children. 

By having a public health care plan, the bill will ensure competition for Americans to have the best health care at the most affordable cost. Also, since everyone will have health care, no one industry or business will be at an advantage over another one.

Health care reform will provide greater choice for all Americans. Americans will be able to keep their doctor and their current plan, if they like what they have. With a high quality public health insurance option competing with private insurers, there will be more choice of providers and more benefits. The important aspect is this—every American will have a choice of providers, versus today’s choice, for the uninsured, of the emergency room or no care at all. No one will be forced into a public option. This will just be one of many choices.

Health care reform will provide higher quality health care for all Americans and businesses. You and your doctor—not insurance companies—will make health care decisions. As more primary care, family doctors, and nurses enter the workforce, even more access is guaranteed for all Americans. Also, the bill mandates coverage for mental health care, a key issue that will affect, in particular, the families of our service members who are returning from the wars in Iraq and Afghanistan.

Health care reform will provide peace of mind. The bill provides a cap on catastrophic coverage—coverage for traumatic injuries such as spinal cord injuries and long-term health care. There will be no more denial of coverage for pre-existing conditions, and no reason to make a life or job decision based on whether or not you or your family will have health care coverage.

We need health insurance reform now! Access to quality, affordable health care is critical to the well-being of all Michiganders and all Americans, today and tomorrow. Central to all of this is addressing the needs of uninsured Americans, strengthening our Medicare system, providing health insurance to low-income children and families, funding research into diseases like diabetes and cancer, and giving patients the ability to make decisions with their doctors—not health insurance companies. An estimated 1,400 families lose health insurance every day that we do not pass health insurance reform.
 
One aspect of this legislation of which I am most proud is its fiscal responsibility. According to a letter dated November 5, 2009, from the non-partisan, objective Congressional Budget Office, this bill does not add one dime to the deficit. Furthermore, this bill reduces the deficit by an estimated $109 billion. This is not only fiscally responsible, but it also allows us to provide health care to the least of our sisters and brothers. 

When this bill is signed into law, 10 provisions of the bill will take effect immediately:

It will begin to close the Medicare Part D “Donut” Hole. The bill reduces the donut hole by $500 per Medicare recipient and institutes a 50% discount on brand-name drugs.

It gets health insurance to the uninsured. By creating a temporary insurance program, health care will be available for people who have been denied a policy due to pre-existing conditions or who have not had health care for several months.

It bans lifetime limits on health care coverage. The bill prohibits health insurance companies from placing lifetime caps on coverage—traditional coverage or catastrophic care coverage.

It provides health insurance for young people. It requires health insurance plans to allow young people through age 26 to remain on their parents’ insurance policy at their parent’s choice.

It eliminates cost-sharing for preventive services in Medicare. It eliminates co-payments for preventive services and exempts preventive services from deductibles under the Medicare program.

It ends health care rescissions. It prohibits insurers from nullifying or “rescinding” a patient’s policy when they file a claim for benefits, except in cases of fraud.

It bans co-payments and deductibles. It eliminates co-payments for preventive services and exempts preventive services from deductibles under the Medicare program.

It increases funding for community health centers. It increases funding for Community Health Centers to allow twice the number of patients seen by Community Health Centers for the next five years.

It increases the number of primary care doctors. It increases the investment by the federal government in training programs to increase the number of primary care doctors, nurses, and public health professionals.

It creates long-term health care for disabled adults. The bill creates a long-term care insurance program to be financed by voluntary payroll deductions to provide benefits to adults who become functionally disabled.

As with Medicare and Medicaid, the federal government has the Constitutional power to reform our health care system. The 10th amendment to the U.S. Constitution states that the powers not delegated to the federal government by the Constitution, nor prohibited by it to the states, are reserved to the states…or to the people. Article One, Section Three, also known as the Commerce Clause, says the same thing.  The Constitution gives Congress broad power to regulate activities that have an effect on interstate commerce. Congress has used this authority to regulate many aspects, from labor relations and education to health care and agricultural production. Since virtually every aspect of the heath care system has an effect on interstate commerce, the power of Congress to regulate health care is essentially unlimited.

The Affordable Health Care for America Act is good for small businesses. Under this legislation, many small businesses will be eligible for a new tax credit to help them provide coverage for their workers and their families—and they or their workers will get access to a new comparison shopping marketplace with low rates and good benefits like large groups get. Without health insurance reform, small businesses would pay nearly $2.4 trillion over the next 10 years in health care costs for their workers. According to the nonpartisan Joint Committee on Taxation—only 1.2 percent of the wealthiest Americans will be subject to the surcharge, and it would only apply to dollars earned over $1 million for a couple and $500,000 for an individual. Furthermore, 86 percent of all businesses are exempt from the requirement to provide health insurance coverage to their workers.

Nothing in the House bill will cut basic Medicare benefits. The Affordable Health Care for America Act strengthens and improves Medicare benefits for older Americans and helps eliminate waste, fraud, and inefficiency from Medicare—including gross overpayments to insurance companies providing Medicare Advantage plans which do nothing to improve care for Medicare Advantage beneficiaries.

The Affordable Health Care for America Act is comprehensive health insurance reform that covers 96 percent of Americans, ensures affordability for the middle class, provides security for our seniors, ends discrimination by insurance companies against the sick, caps what Americans pay out-of-pocket, and protects our children’s future by not adding to our deficit.

Finally, health care reform will allow the United States to catch up to the rest of the industrialized world. We are the ONLY nation that does not provide universal health care coverage to its citizens. This puts the health of not only individual Americans at jeopardy, but it also puts the health of our economy in jeopardy. Businesses that have to compete with China, India, Europe, and other countries are doing so on an uneven, unfair playing field, because while businesses in China, India, and Europe do not have to pay for health care, American businesses do. Health care reform will allow these businesses to truly compete on a global plane.

I applaud my colleagues in the House of Representatives for supporting this legislation and ensuring that health care is accessible, available, and affordable for all Americans and American businesses. Two generations is long enough for the American people to wait for comprehensive health care reform. Health care is the key moral and economic imperative for our nation and this Congress. We must reform health care now.


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